Provider Demographics
NPI:1982914420
Name:COX, SERENA M (OD)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:M
Last Name:COX
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11557 NW PINYON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-7508
Mailing Address - Country:US
Mailing Address - Phone:407-625-9451
Mailing Address - Fax:
Practice Address - Street 1:7016 SW NYBERG ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9231
Practice Address - Country:US
Practice Address - Phone:503-692-2020
Practice Address - Fax:503-629-8421
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002428152W00000X
CA15454152W00000X
ORAT4649152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist